Opioid Tolerance in Methadone Maintenance Treatment: Comparison of Methadone & Levomethadone in Long-Term Treatment
BACKGROUND:
This
study aimed to investigate the development of opioid tolerance in patients
receiving long-term methadone maintenance treatment (MMT).
METHODS:
A
region-wide cross-sectional study was performed focusing on dosage and duration
of treatment. Differences between racemic methadone and levomethadone were
examined. All 20 psychiatric hospitals and all 110 outpatient clinics in Berlin
licensed to offer MMT were approached in order to reach patients under MMT
fulfilling the DSM IV criteria of opiate dependence. In the study, 720 patients
treated with racemic methadone or levomethadone gave information on the dosage
of treatment. Out of these, 679 patients indicated the duration of MMT.
RESULTS:
Treatment
with racemic methadone was reported for 370 patients (54.5 %), with
levomethadone for 309 patients (45.5 %). Mean duration of MMT was
7.5 years. We found a significant correlation between dosage and duration
of treatment, both in a conjoint analysis for the two substances racemic
methadone and levomethadone and for each substance separately. These effects
remained significant when only patients receiving MMT for 1 year or longer
were considered, indicating proceeding tolerance development in long-term
treatment. When correlations were compared between racemic methadone and
levomethadone, no significant difference was found.
CONCLUSIONS:
Our
data show a tolerance development under long-term treatment with both racemic
methadone and levomethadone. Tolerance development did not differ significantly
between the two substances.
- 1Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. stefan.gutwinski@charite.de.
- 2Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Nikola.Schoofs@charite.de.
- 3Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Heiner.Stuke@charite.de.
- 4Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. t.riemer@alexius.de.de.
- 5Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Corinde.Wiers@gmail.com.
- 6Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Felix.Bermpohl@charite.de.
- Harm Reduct J. 2016 Feb 16;13(1):7. doi: 10.1186/s12954-016-0095-0.
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